Osgood-Schlatter’s Disease

Master Patient Information DocumentOsgood-Schlatter’s Disease What is Osgood-Schlatter’s Disease?
Osgood-Schlatter’s disease (OSD) is a term used to describe localised pain felt below the knee
cap on the shin bone (tibial tuberosity) where the patellar tendon inserts. It mainly presents in
young people who participate in regular high impact sports and are going through a growth
spurt (1).
The large quadriceps muscle on the front of the thigh facilitates straightening the knee by pulling
on the kneecap (patella) and the patellar tendon which attaches to the front of the shin bone.
Continued stress and traction from the quadriceps muscle in the area of this attachment can
cause pain and swelling. As this heals a hard bony bump may develop (2).
Osgood-Schlatter’s usually presents on the one knee but both can be affected. It has a gradual
onset and is commonly exacerbated by sporting activities, growth spurts, and kneeling.
Thigh muscles- front view Knee joint- front view
What are the symptoms of Osgood- Schlatter’s?
The most common symptoms of OSD are pain and swelling at the bony part of the top of the
shin bone, under the knee with a tenderness to touch. It is commonly not painful unless taking
part in certain sports or when you kneel. Symptoms usually appear around puberty (10-14
years) when growth spurts occur. Diagnosis is often clear from the typical symptoms and no x-
rays or scans are routinely needed.
Page 2 of 6
• Pain relief medication (as advised by your doctor or pharmacist)
• Pacing the amount of activity that you do and introducing rest periods into activity as not
to exacerbate your knee pain
• Using ice packs (caution of ice burns) on the sore area after activity
• Participating in the below course of physiotherapy exercises.
The symptoms will commonly improve as growth slows over 12-24 months (3).
Physiotherapy for Osgood- Schlatter’s
The best way to manage OSD is to stretch the tight muscles to reduce stress and irritation at
the area of the quadriceps insertion below the kneecap. The physiotherapy exercise should not
exacerbate the pain but a stretch sensation should be felt in the muscle.
If the stretches are irritating the knee pain try completing them after a warm bath or shower. If
the exercises still continue to cause knee pain then a full assessment with a physiotherapist
would be recommended to review the knee pain further.
Additional physiotherapy management strategies also include massage, taping, bracing and
review of muscular imbalances.
The exercises should be completed daily, preferably morning and evening and especially before
any physical activity.
Exercise 1 – Quadriceps (thigh) stretches
Exercise 2 – Gastrocnemius (calf) stretch
• Lie on your back on a bed/table. • Bend your knees and drop one leg over
the side of the bed. Hold onto your ankle or a towel/band around your ankle.
• Gently draw your foot towards your buttock. You should feel the stretch in the front of your thigh.
• Hold for 30 seconds. Repeat 3 times a day on each leg.
• Place your hands against a wall for stability. Bend the right leg and step the left leg back at least a foot's distance, keeping it straight. Both feet should be flat on the floor.
• The left calf muscle is stretched by keeping the left leg as straight as possible and the left heel on the floor.
• Repeat with the opposite leg. • Hold for 5 seconds. • Repeat 5 times each leg, 3 times a
day.
How quickly will my exercises start to make a difference?
Usually, you will not feel any noticeable difference for at least 3 weeks, but your knee should
start to feel more comfortable after about 8 weeks. Unfortunately, some symptoms can last for
12-24 months as growth slows. If you find the exercises increase your knee pain or it hurts your
knee to do them then you should stop doing them. If the exercises fail to work, you should see
your Consultant or GP to ask for a referral to physiotherapy for a more in-depth assessment and
individualised treatment programme.
Flare up management – This knee pain can sometimes return with another period of growth or
sharp increase or decrease in activity and therefore the initial advice would be to restart the
exercises.
How soon will I be able to return to normal activities?
Sport or physical activity is not likely to cause any permanent damage but may make your pain
worse. If the pain is affecting how you do your sport, you may need to think about how often you
train. Reducing strenuous or vigorous sport may be sensible until the pain lessens to a level you
can cope with. You should aim to reduce how long, how often and how much exercise you do
when the knee is very painful. This is especially important if this exercise includes running or
jumping. You may need to consider a complete break from sport for a while if pain remains
severe. After a few weeks slowly reintroduce the exercises and sport and pace your return to
previous level.
• Sitting on the floor, keep your legs straight in front of you, and reach forwards to touch your toes.
• Go as far as feels comfortable. • You will feel a stretch in your
Hamstrings (at the back of your thigh) and maybe your lower back as well.
• Repeat with the opposite leg. • Hold for 5 seconds. • Repeat 5 times each leg, 3 times a
day.
• https://apcp.csp.org.uk/system/files/osgood_schlatters_disease_2015.pdf Important information The information in this leaflet is for guidance purposes only and is not provided to replace professional clinical advice from a qualified practitioner.
Disclaimer Please note this is a generic ESHT information sheet. If you have specific questions about how this relates to your child, please ask your doctor. Please note this information may not necessarily reflect treatment at other hospitals. Your comments We are always interested to hear your views about our leaflets. If you have any comments, please contact the Patient Experience Team – Tel: 0300 131 4731 (direct dial) or by email at: [email protected] Hand hygiene The Trust is committed to maintaining a clean, safe environment. Hand hygiene is very important in controlling infection. Alcohol gel is widely available at the patient bedside for staff use and at the entrance of each clinical area for visitors to clean their hands before and after entering. Other formats If you require any of the Trust leaflets in alternative formats, such as large print or alternative languages, please contact the Equality and Human Rights Department.
Tel: 0300 131 4434 Email: [email protected] After reading this information are there any questions you would like to ask? Please list below and ask your nurse or doctor. _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________
Page 6 of 6
References (1) Osgood-Schlatter disease | Health topics A to Z | CKS | NICE. (2021). Retrieved 12
February 2021, from https://cks.nice.org.uk/topics/osgood-schlatter-disease/
Disease information for parents and young people [Ebook]. Retrieved from
https://apcp.csp.org.uk/system/files/osgood_schlatters_disease_2015.pdf
(3) Circi, E., Atalay, Y., & Beyzadeoglu, T. (2017). Treatment of Osgood–Schlatter disease:
Review of the literature. Musculoskeletal Surgery, 101(3), 195-200.
doi:http://dx.doi.org.ezproxy.brighton.ac.uk/10.1007/s12306-017-0479-7
The following clinicians have been consulted and agreed this patient information:
The directorate group that have agreed this patient information leaflet:
ukCreated by Sofia Alikampioti (Physiotherapy student) with the supervision of;
Jess Pitman (Paediatric Musculoskeletal Physiotherapist)
Lucy Cassidy (Paediatric Musculoskeletal Physiotherapist)
Next review date: March 2024
Responsible clinician/author: Jess Pitman Paediatric Musculoskeletal Physiotherapist
© East Sussex Healthcare NHS Trust – www.esht.nhs.uk